{"title":"Is Stable CAD the Same in All Circumstances? The Curious Case of PCI Before TAVR.","authors":"Neil J Wimmer, Robert W Yeh","doi":"10.1161/CIRCINTERVENTIONS.126.016576","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016576","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016576"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jung-Min Ahn, Sant Kumar, Euihong Ko, Gossadi Mohammed, Kentaro Hayashida, Wei-Hsian Yin, Hasan Jilaihawi, Raj Makkar, Won-Keun Kim, Tullio Palmerini, Soo Yeon An, Ju Hyeon Kim, Do-Yoon Kang, Joon Bum Kim, David J Cohen, Davide Capodanno, Duk-Woo Park, Seung-Jung Park
{"title":"Transcatheter Aortic Valve Replacement for Severe Bicuspid Aortic Valve Stenosis.","authors":"Jung-Min Ahn, Sant Kumar, Euihong Ko, Gossadi Mohammed, Kentaro Hayashida, Wei-Hsian Yin, Hasan Jilaihawi, Raj Makkar, Won-Keun Kim, Tullio Palmerini, Soo Yeon An, Ju Hyeon Kim, Do-Yoon Kang, Joon Bum Kim, David J Cohen, Davide Capodanno, Duk-Woo Park, Seung-Jung Park","doi":"10.1161/CIRCINTERVENTIONS.125.016014","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016014","url":null,"abstract":"<p><p>Surgical aortic valve (AV) replacement has been the standard treatment for patients with severe symptomatic degenerative AV stenosis (AS). In recent years, transcatheter AV replacement has emerged as an established alternative in selected patient populations, supported by robust evidence in tricuspid AS. However, there has been limited evaluation of transcatheter AV replacement in bicuspid AV AS. Recently, several observational studies have demonstrated the feasibility and safety of transcatheter AV replacement in bicuspid AV AS, and the use of newer-generation devices has shown encouraging outcomes. However, the incidence of procedural complications such as paravalvular regurgitation, permanent pacemaker implantation, and aortic root injury was more frequent in patients with bicuspid AV AS compared with tricuspid AS. We review the clinical evidence of transcatheter AV replacement for bicuspid AV AS and suggest the appropriate criteria for patient and device selection, implantation techniques, and further management.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016014"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic Implications of Bleeding and Ischemic Complications in Acute Myocardial Infarction-Related Cardiogenic Shock Managed With Microaxial Flow Pump.","authors":"Takahiro Suzuki, Taku Asano, Tomohiro Shinozaki, Shun Kohsaka, Takahiro Nakashima, Masafumi Ono, Atsushi Mizuno, Jiro Aoki","doi":"10.1161/CIRCINTERVENTIONS.125.015676","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015676","url":null,"abstract":"<p><strong>Background: </strong>Microaxial flow pumps are emerging therapeutic devices for acute myocardial infarction-related cardiogenic shock. However, prognostic implications of hemorrhagic and ischemic complications on mortality remain limited. We aim to clarify the incidence of these complications in acute myocardial infarction-related cardiogenic shock requiring a microaxial flow pump and their associations with mortality.</p><p><strong>Methods: </strong>We analyzed patients from the J-PVAD (Japan Registry for Percutaneous Ventricular Assist Device) who underwent microaxial flow pump implantation for acute myocardial infarction-related cardiogenic shock between 2020 and 2023. Primary composite exposures were bleeding complications (nonintracranial bleeding, including access site bleeding and nonintracranial bleeding requiring blood transfusion, and intracranial hemorrhage) and ischemic complications (lower limb ischemia, recurrent myocardial infarction, noncerebral embolism, or ischemic stroke). The primary outcome was in-hospital all-cause mortality. Cumulative incidences were estimated with death as a competing event. Cox regression with time-varying exposures assessed associations between complications and mortality, adjusting for clinical characteristics. Population attributable fractions of complications for death were calculated, indicating the proportion of mortality that could theoretically be prevented if the complications were eliminated.</p><p><strong>Results: </strong>Of 2034 patients (mean age, 69.2±11.7 years; 17.6% women), 840 (41.3%) died during hospitalization. The 30-day cumulative incidence was 23.2% (95% CI, 21.4%-25.0%) for bleeding complications and 10.5% (95% CI, 9.1%-11.8%) for ischemic complications. Both complications were independently associated with increased mortality (adjusted hazard ratio, 1.60 [95% CI, 1.30-1.97] for bleeding; adjusted hazard ratio, 1.74 [95% CI, 1.24-2.44] for ischemic complications). The population attributable fraction of bleeding complications was 10.7% (95% CI, 6.6%-14.0%), compared with 4.0% (1.8%-5.6%) for ischemic complications, suggesting that bleeding events contributed substantially to the mortality burden.</p><p><strong>Conclusions: </strong>Both bleeding and ischemic complications remain frequent adverse events in acute myocardial infarction-related cardiogenic shock requiring a microaxial flow pump. While both complications were significantly associated with mortality, the higher incidence of bleeding complications contributed to a greater mortality burden. This underscores the importance of bleeding prevention strategies alongside ischemic complication management in this high-risk population.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015676"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uwe Zeymer, Jacob Eifer Møller, Anne Freund, Matthias Hochadel, Ibrahim Akin, Jose P S Henriques, Melchior Seyfarth, Daniel Burkhoff, Jan Bělohlávek, Steffen Massberg, Marcus D Flather, Steffen Schneider, Steffen Desch, Dirk Westermann, Christian Hassager, Holger Thiele
{"title":"Impact of Age ≥75 Years on the Efficacy and Safety of Mechanical Circulatory Support Devices in Infarct-Related Cardiogenic Shock: Meta-Analysis With Individual Patient Data.","authors":"Uwe Zeymer, Jacob Eifer Møller, Anne Freund, Matthias Hochadel, Ibrahim Akin, Jose P S Henriques, Melchior Seyfarth, Daniel Burkhoff, Jan Bělohlávek, Steffen Massberg, Marcus D Flather, Steffen Schneider, Steffen Desch, Dirk Westermann, Christian Hassager, Holger Thiele","doi":"10.1161/CIRCINTERVENTIONS.125.016182","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016182","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016182"},"PeriodicalIF":7.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fleur W Adriaansen, Caïa Crooijmans, Tijn P J Jansen, Behruz Yosofi, Joan G Meeder, Yolande Appelman, Marcel A M Beijk, Tim P van de Hoef, Timo Nijkamp, Hester M den Ruijter, Annemiek M J de Vos, Valeria Paradies, Martijn Meuwissen, Nicola S Vos, Els G M Olde Bijvank, Ibtihal Al Amri, Melina C den Haan, Jonathan Halim, Stijn C H van den Oord, Karin Arkenbout, Marlies M Kok, Pier Woudstra, Tessel N E Vossenberg, Nick D Fagel, Ton A C M Heestermans, Jan H Cornel, Niels van Royen, Suzette E Elias-Smale, Aukelien C Dimitriu-Leen, Peter Damman
{"title":"Diagnostic Yield and Safety of Invasive Coronary Function Testing After Radial Versus Femoral Access.","authors":"Fleur W Adriaansen, Caïa Crooijmans, Tijn P J Jansen, Behruz Yosofi, Joan G Meeder, Yolande Appelman, Marcel A M Beijk, Tim P van de Hoef, Timo Nijkamp, Hester M den Ruijter, Annemiek M J de Vos, Valeria Paradies, Martijn Meuwissen, Nicola S Vos, Els G M Olde Bijvank, Ibtihal Al Amri, Melina C den Haan, Jonathan Halim, Stijn C H van den Oord, Karin Arkenbout, Marlies M Kok, Pier Woudstra, Tessel N E Vossenberg, Nick D Fagel, Ton A C M Heestermans, Jan H Cornel, Niels van Royen, Suzette E Elias-Smale, Aukelien C Dimitriu-Leen, Peter Damman","doi":"10.1161/CIRCINTERVENTIONS.125.016450","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.125.016450","url":null,"abstract":"<p><strong>Background: </strong>Coronary vasomotor dysfunction is diagnosed by a coronary function testing (CFT). However, protocols vary, and the influence of access site and concomitant vasodilator medication on the diagnostic yield and safety of CFT is unclear. This study assessed the diagnostic yield and safety of CFT by radial access with intraarterial calcium channel blockers compared with CFT by femoral access.</p><p><strong>Methods: </strong>Data were obtained from the Netherlands Registry of Invasive Coronary Vasomotor Function Testing, a Dutch multicenter collaboration on coronary function testing. Patients who underwent CFT between December 2020 and July 2025 were included.</p><p><strong>Results: </strong>A total of 1885 patients were included, 1436 (76.2%) with primary radial access and 380 (20.2%) with primary femoral access. In 69 (3.7%) patients conversion from radial to femoral access was necessary. The conversion group was analyzed separately. The total diagnostic yield of coronary vasomotor dysfunction was 78.5%. There was no significant difference in the prevalence of coronary vasomotor dysfunction between patients with primary radial versus femoral access (79.2% versus 75.3%; <i>P</i>=0.1). There was also no difference in total diagnostic yield between the group without conversion and the conversion group (78.4% versus 82.6%; <i>P</i>=0.4); however, spasm was more prevalent in the conversion group (67.7% versus 79.4%; <i>P</i>=0.04). There were no differences in CFT complication rates between groups.</p><p><strong>Conclusions: </strong>Primary radial access with routine administration of calcium channel blockers was not associated with a lower diagnostic yield in CFT than primary femoral access. Procedural safety was comparable.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016450"},"PeriodicalIF":7.4,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael R Hainstock, Gregory Fleming, Dennis Kim, Jamil Aboulhosn, Daniel Levi, Richard Krasuski, Robert Sommer, Alejandro J Torres, Robert Gray, Dean Kereiakes, Andrew Leventhal, Matthew Gillespie, Wilson Szeto, Alan Zajarias, Shabana Shahanavaz, Zachary L Steinberg, Thomas K Jones, Vaikom S Mahadevan, Phillip Moore, Sammy Elmariah, Girish Shirali, Wenhao Li, Vasilis Babaliaros, D Scott Lim
{"title":"Five-Year Outcomes for Patients With RVOT Dysfunction Treated With the SAPIEN 3 Transcatheter Heart Valve: A Pooled Analysis From the COMPASSION S3 Trial.","authors":"Michael R Hainstock, Gregory Fleming, Dennis Kim, Jamil Aboulhosn, Daniel Levi, Richard Krasuski, Robert Sommer, Alejandro J Torres, Robert Gray, Dean Kereiakes, Andrew Leventhal, Matthew Gillespie, Wilson Szeto, Alan Zajarias, Shabana Shahanavaz, Zachary L Steinberg, Thomas K Jones, Vaikom S Mahadevan, Phillip Moore, Sammy Elmariah, Girish Shirali, Wenhao Li, Vasilis Babaliaros, D Scott Lim","doi":"10.1161/CIRCINTERVENTIONS.125.016361","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.125.016361","url":null,"abstract":"<p><strong>Background: </strong>The COMPASSION S3 trial was designed to evaluate the safety and effectiveness of the SAPIEN 3 transcatheter heart valve (THV) for transcatheter pulmonic valve replacement in patients with a dysfunctional right ventricular outflow tract (RVOT) conduit or previously implanted valve in the pulmonic position. Here, 5-year clinical and hemodynamic outcomes for patients in the main cohort and the continued access protocol are reported.</p><p><strong>Methods: </strong>The COMPASSION S3 trial was a single-arm, multicenter study enrolling patients with moderate-to-severe pulmonic regurgitation and a mean RVOT gradient ≥35 mm Hg. The primary end point was THV dysfunction at 1 year, a nonhierarchical composite of RVOT reintervention, ≥moderate total pulmonic regurgitation, and mean RVOT gradient >40 mm Hg. Clinical and echocardiographic outcomes were assessed at baseline, discharge, 30 days, 6 months, 1 year, and then annually to 5 years.</p><p><strong>Results: </strong>Between 2016 and 2020, 69 patients were enrolled and successfully implanted with the SAPIEN 3 THV. The mean patient age was 32.1 years, and most patients (70.8%) had a conduit as the most recent prior intervention. At 5 years, the rate of THV dysfunction was 12.0%: 3 patients required reintervention, 2 patients had ≥moderate pulmonic regurgitation, and 1 patient had a mean gradient >40 mm Hg. There were 3 cases of device-related endocarditis (4.4%). One death occurred on postoperative day 560 due to cardiogenic shock. No cases of tricuspid valve injury, stent fractures, or valve malposition were reported. Post-transcatheter pulmonic valve replacement, mean gradients were low and stable through 5-year follow-up. Through 5 years, >95% of patients had ≤mild total pulmonic regurgitation, and 97.9% of patients had none/trace paravalvular regurgitation.</p><p><strong>Conclusions: </strong>Five-year results from the COMPASSION S3 trial demonstrate that the SAPIEN 3 THV provides durable RVOT relief with low rates of reintervention or endocarditis, supporting the device as a safe and versatile option for transcatheter pulmonic valve replacement across diverse anatomies and clinical scenarios.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02744677.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016361"},"PeriodicalIF":7.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emmanuel De Cock, Tom Adriaenssens, Francis Stammen, Marc Vanderheyden, Christophe Dubois, Maarten Vanhaverbeke, Bert Ferdinande, Charles Pirlet, Francois Simon, Bert Vandeloo, Lesizza Pierluigi, Liesbeth Rosseel, Adel Aminian, Benjamin Scott, Frédéric De Vroey, Emma Christiaen, Jean-Benoît le Polain de Waroux, Jan Van der Heyden, Ian Buysschaert
{"title":"Rapid Atrial Pacing-Induced Wenckebach Atrioventricular Block: A Poor Predictor of Permanent Pacemaker Need Post-TAVR.","authors":"Emmanuel De Cock, Tom Adriaenssens, Francis Stammen, Marc Vanderheyden, Christophe Dubois, Maarten Vanhaverbeke, Bert Ferdinande, Charles Pirlet, Francois Simon, Bert Vandeloo, Lesizza Pierluigi, Liesbeth Rosseel, Adel Aminian, Benjamin Scott, Frédéric De Vroey, Emma Christiaen, Jean-Benoît le Polain de Waroux, Jan Van der Heyden, Ian Buysschaert","doi":"10.1161/CIRCINTERVENTIONS.125.016145","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.125.016145","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of rapid atrial pacing (RAP)-induced Wenckebach atrioventricular block (W-AVB) as a diagnostic test for predicting permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) remains unclear and requires further validation. The objective of this study was to evaluate the predictive value of RAP-induced W-AVB for PPI and sudden cardiac death within 30 days post-TAVR.</p><p><strong>Methods: </strong>This prospective, investigator-initiated, multicenter study (PACE-TAVR) included 640 patients undergoing TAVR across 12 centers. RAP was performed before and after TAVR to assess for W-AVB. Using negative predictive values and negative likelihood ratios, the predictive value of W-AVB was evaluated for the primary end point: sudden cardiac death or guideline-based indications for permanent pacemaker implantation, including complete atrioventricular block or alternating bundle branch block (Class I), and preexisting conduction disturbances with new ECG changes, new-onset left bundle branch block, a positive electrophysiology study, or sinus node dysfunction (Class II).</p><p><strong>Results: </strong>RAP was successfully performed post-TAVR in 556 patients, with RAP-induced W-AVB observed in 192 (34.5%). W-AVB was associated with baseline conduction disturbances, amiodarone use, pre-TAVR RAP-induced W-AVB, and anesthesia type. The primary end point was more frequent in patients with W-AVB (15.6% versus 9.3%; odds ratio, 1.80 [95% CI, 1.06-3.04]; <i>P</i>=0.029). However, the absence of W-AVB had a negative predictive value of only 90.7% and a poor negative likelihood ratio (0.79). The test's utility declined in subgroups at high risk for PPI, including self-expanding valve recipients (odds ratio, 1.47 [95% CI, 0.84-2.58]; negative predictive value, 88.4%; negative likelihood ratio, 0.86) and patients with a baseline or new left bundle branch block (odds ratio, 1.14 [95% CI, 0.54-2.42]; negative predictive value, 81.3%; negative likelihood ratio, 0.95).</p><p><strong>Conclusions: </strong>RAP-induced W-AVB demonstrates limited utility in predicting post-TAVR PPI or sudden cardiac death, particularly in patients at high risk for PPI. Clinicians should be cautious when using this test for post-TAVR rhythm management.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT05278585.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016145"},"PeriodicalIF":7.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giulio Russo, Daniela Pedicino, Marianna Adamo, Hannes Alessandrini, Martin Andreas, Daniel Braun, Kim A Connelly, Paolo Denti, Rodrigo Estevez-Loureiro, Neil Fam, Rebecca T Hahn, Claudia Harr, Joerg Hausleiter, Daniel Kalbacher, Edwin Ho, Azeem Latib, Edith Lubos, Sebastian Ludwig, Philipp Lurz, Marco Metra, Vanessa Monivas, Georg Nickenig, Giovanni Pedrazzini, Alberto Pozzoli, Fabien Praz, Josep Rodes-Cabau, Christian Besler, Karl-Philipp Rommel, Joachim Schofer, Andrea Scotti, Nicolò Lentini, Roberta Pastorino, Kerstin Piayda, Horst Sievert, Gilbert H L Tang, Isaac Pascual, Holger Thiele, Florian Schlotter, Giuseppe Massimo Sangiorgi, Ralph Stephan von Bardeleben, John Webb, Stephan Windecker, Martin Leon, Maurice Enriquez-Sarano, Francesco Maisano, Stefan Bloechlinger, Maurizio Taramasso
{"title":"Impact of Proportionality of Secondary Tricuspid Regurgitation on Outcomes After Tricuspid Transcatheter Edge-to-Edge Repair.","authors":"Giulio Russo, Daniela Pedicino, Marianna Adamo, Hannes Alessandrini, Martin Andreas, Daniel Braun, Kim A Connelly, Paolo Denti, Rodrigo Estevez-Loureiro, Neil Fam, Rebecca T Hahn, Claudia Harr, Joerg Hausleiter, Daniel Kalbacher, Edwin Ho, Azeem Latib, Edith Lubos, Sebastian Ludwig, Philipp Lurz, Marco Metra, Vanessa Monivas, Georg Nickenig, Giovanni Pedrazzini, Alberto Pozzoli, Fabien Praz, Josep Rodes-Cabau, Christian Besler, Karl-Philipp Rommel, Joachim Schofer, Andrea Scotti, Nicolò Lentini, Roberta Pastorino, Kerstin Piayda, Horst Sievert, Gilbert H L Tang, Isaac Pascual, Holger Thiele, Florian Schlotter, Giuseppe Massimo Sangiorgi, Ralph Stephan von Bardeleben, John Webb, Stephan Windecker, Martin Leon, Maurice Enriquez-Sarano, Francesco Maisano, Stefan Bloechlinger, Maurizio Taramasso","doi":"10.1161/CIRCINTERVENTIONS.125.016269","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.125.016269","url":null,"abstract":"<p><strong>Background: </strong>The impact of proportionality to heart valve regurgitation has been widely investigated in mitral regurgitation, helping to better characterize the best candidates for therapies. However, it has never been studied in tricuspid regurgitation (TR). The aim of the present study is to investigate the impact of the proportionality of TR on outcomes.</p><p><strong>Methods: </strong>Patients undergoing tricuspid transcatheter edge-to-edge repair were selected from the TRIVALVE registry (International Multisite Transcatheter Tricuspid Valve Therapies Registry). Patients were divided according to the ratio between effective regurgitant orifice area (EROA) and right ventricular (RV) end diastolic diameter (RVEDD) into tertiles: patients with low EROA/RVEDD (RV, dominant); intermediate EROA/RVEDD (right ventricle and TR, RV-TR, codominant), and high EROA/RVEDD (TR, TR, dominant). The primary outcome was all-cause mortality. Median follow-up was 9.7 months (4.2-12.0).</p><p><strong>Results: </strong>A total of 204 patients were included in the present study: 67 for the RV dominant, 68 for the RV-TR codominant, and 69 for the TR dominant group. The 3 groups presented different baseline characteristics. Survival analysis among the 3 groups showed a trend towards worse prognosis for the RV-dominant group, as compared with the RV-TR codominant and TR dominant groups.</p><p><strong>Conclusions: </strong>The conceptual framework of proportionality is applicable to TR with EROA/RVEDD, defining a higher risk RV-dominant phenotype with a trend towards worse survival after tricuspid transcatheter edge-to-edge repair.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016269"},"PeriodicalIF":7.4,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Akrasia: The Evidence-Action Gap in Peripheral Artery Disease.","authors":"Adnan Halboni, Herbert D Aronow","doi":"10.1161/CIRCINTERVENTIONS.126.016677","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.016677","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016677"},"PeriodicalIF":7.4,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}